The Association Between the Serum Sodium Level & Severity of Complications of Chronic Liver Disease - A Hospital-Based Observational Study
DOI:
https://doi.org/10.71393/x9m5yy29Keywords:
Chronic liver disease, Hyponatremia, Cirrhosis, Prognosis, MELD score, Child-Pugh scoreAbstract
Introduction: Chronic liver disease (CLD) leads to cirrhosis and complications like ascites and encephalopathy. Hyponatremia, often resulting from impaired solute-free water clearance, is common in these patients. This study evaluates the association between serum sodium levels and the severity of complications in CLD.
Aims & Objective: To evaluate the association between serum sodium levels and the severity of complications in CLD, establish hyponatremia as a prognostic marker, identify complications at different sodium levels, and estimate short-term survival rates.
Materials & Methods: This hospital-based observational study was conducted at Tezpur Medical College and Hospital over one year (2024-2025) on 278 patients with liver cirrhosis. Diagnosis was confirmed by ultrasonography. Serum sodium levels were correlated with complications, severity scores (Child-Pugh, MELD), 28-day morbidity, and mortality using appropriate statistical tests.
Results: A strong, statistically significant association was observed between lower serum sodium levels and increased severity of complications (p<0.001). Patients with sodium <130 mEq/L had the highest rates of severe complications (43%), Child-Pugh Class C (100%), and higher mean MELD scores (26.72±4.38). Hyponatremia was significantly associated with ascites, hepatorenal syndrome, variceal bleeding, SBP, and higher grades of hepatic encephalopathy (p<0.001 for all). Strong negative correlations were found between sodium and both the Child-Pugh (r = -0.84) and MELD (r = -0.81) scores. Twenty-eight-day morbidity (100%) and mortality (24%) were highest in the <130 mEq/L group. ROC analysis identified a serum sodium cut-off of 131.5 mEq/L for predicting 28-day mortality (AUC 0.67).
Conclusion: Serum sodium is a simple, valuable prognostic marker in CLD. Hyponatremia is strongly associated with more severe complications, advanced liver disease, and higher short-term morbidity and mortality.
